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Sequential Double Autotransplantation Using Immature Teeth as First-Stage Autotransplants to Preserve Alveolar
Miks Lejnieks1,2,3,4, Juan E Onetto5,6, Marie-Therese Flores5,6
1Department of Oral and Maxillofacial Surgery and Oral Medicine, Rīga Stradiņš University, Rīga, Latvia, rsu.lv.
Case Reports in Dentistry
|June 22, 2026
Summary
This study introduces a two-stage tooth autotransplantation technique for growing patients with severe bone defects. The method preserves alveolar bone and promotes regeneration, offering a viable alternative to implants.
Area of Science:
- Dentistry
- Oral Surgery
- Regenerative Medicine
Background:
- Missing teeth in growing patients pose challenges for alveolar bone preservation and continued development.
- Autotransplantation is a biological alternative to implants but faces hurdles with compromised recipient sites and immature donor teeth.
Purpose of the Study:
- To describe a sequential double autotransplantation protocol for preserving alveolar architecture and promoting bone regeneration in severely compromised cases.
- To evaluate the efficacy of using immature first-stage autotransplants to exploit osteogenic potential for alveolar bone regeneration.
Main Methods:
- A case series involving three patients (ages 16-18) with severe bone defects underwent a planned two-stage autotransplantation.
- Cone-beam computed tomography (CBCT)-guided planning and 3D-printed templates were utilized to minimize extra-alveolar time.
- Immature donor teeth served as first-stage transplants, followed by secondary transplantation with a more mature donor after 12 months.
Main Results:
- All cases demonstrated favorable outcomes at 24 months post-second-stage autotransplantation.
- Outcomes included pulp chamber obliteration without periapical pathology, indicating maintained pulp vitality and continued root development.
- Periodontal probing depths remained favorable at 2-3 mm at the final follow-up.
Conclusions:
- Recipient site condition, not solely donor tooth development, is the primary determinant of prognosis in severely compromised cases.
- A staged autotransplantation protocol can effectively preserve alveolar architecture for definitive rehabilitation.
- Larger controlled studies are necessary to validate these findings.
